Echocardiographic characteristics of patients with SARS-CoV-2 infection

Abstract Background Myocardial involvement induced by SARS-CoV-2 infection might be important for long-term prognosis. The aim of this observational study was to characterize the myocardial effects during SARS-CoV-2 infections by echocardiography. Results and methods An extended echocardiographic image acquisition protocol was performed in 18 patients with SARS-CoV-2 infection assessing LV longitudinal, radial, and circumferential deformation including rotation, twist, and untwisting. Furthermore, LV deformation was analyzed in an age-matched control group of healthy individuals (n = 20). The most prevalent finding was a reduced longitudinal strain observed predominantly in more than one basal LV segment (n = 10/14 patients, 71%). This pattern reminded of a “reverse tako-tsubo” morphology that is not typical for other viral myocarditis. Additional findings included a biphasic pattern with maximum post-systolic or negative regional radial strain predominantly basal (n = 5/14 patients, 36%); the absence or dispersion of basal LV rotation (n = 6/14 patients, 43%); a reduced or positive regional circumferential strain in more than one segment (n = 7/14 patients, 50%); a net rotation showing late post-systolic twist or biphasic pattern (n = 8/14 patients, 57%); a net rotation showing polyphasic pattern and/or higher maximum net values during diastole (n = 8/14 patients, 57%). Conclusion Myocardial involvement due to SARS-CoV-2-infection was highly prevalent in the present cohort—even in patients with mild symptoms. It appears to be characterized by specific speckle tracking deformation abnormalities in the basal LV segments. These data set the stage to prospectively test whether these parameters are helpful for risk stratification and for the long-term follow-up of these patients.

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Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

Ear Nose & Throat Journal ◽

10.1177/0145561320986030 ◽

2021 ◽

pp. 014556132098603

Author(s):

Anni Koskinen ◽

Marie Lundberg ◽

Markus Lilja ◽

Jyri Myller ◽

Matti Penttilä ◽

...

Keyword(s):

Maxillary Sinus ◽

Revision Surgery ◽

University Hospital ◽

Sinus Surgery ◽

Control Group ◽

University Hospitals ◽

Balloon Sinuplasty ◽

Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

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Long-Term Follow-Up of Biopsy-Proven Viral Myocarditis

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2012.01.007 ◽

2012 ◽

Vol 59 (18) ◽

pp. 1604-1615 ◽

Cited By ~ 256

Author(s):

Stefan Grün ◽

Julia Schumm ◽

Simon Greulich ◽

Anja Wagner ◽

Steffen Schneider ◽

...

Keyword(s):

Viral Myocarditis ◽

Long Term Follow Up

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Abstract 165: Pial Synangiosis in Patients with Moyamoya less than 2 Years of Age

Stroke ◽

10.1161/str.43.suppl_1.a165 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Eric M Jackson ◽

Ning Lin ◽

Lissa Baird ◽

R. Michael Scott ◽

Edward R Smith

Keyword(s):

Late Complications ◽

High Risk Population ◽

Consecutive Series ◽

Ischemic Change ◽

Initial Surgery ◽

Long Term Follow Up ◽

Progression Of Disease ◽

Long Term Prognosis

Introduction: Moyamoya patients under two years of age represent a therapeutic challenge because of their frequent neurologic instability and concomitant anesthetic risks. We report our experience with pial synangiosis revascularization in this population. Methods: We reviewed the clinical and radiographic records of all patients with moyamoya syndrome in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results: During a 12-year period (1994-2005), thirty-four procedures (15 bilateral, 4 unilateral) were performed in 19 patients under two years of age (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or TIA. Average age at first surgery was 1.4 years (range 6 months to 1.9 years). Unanticipated staged operations occurred in three patients, two due to persistent EEG changes during the initial surgery and one due to brain swelling during the procedure requiring ventriculostomy. There were two perioperative strokes; both patients had post-operative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14). In long term follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures years later for frontal lobe ischemia (2), late infarction (1) and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre and post-operative angiography demonstrated progression of disease. Conclusions: Despite the challenges inherent to this population, the majority of children with moyamoya under 2 years of age have a good long-term prognosis. Our data support the use of pial synangiosis as a safe, effective and durable method for treatment of moyamoya for most children in this potentially high-risk population.

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Abstract 13882: Impact of Ischemic Mitral Regurgitation on Long-Term Prognosis in Patients With Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention

Circulation ◽

10.1161/circ.130.suppl_2.13882 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Kitae Kim ◽

Shuichiro Kaji ◽

Takeshi Kitai ◽

Atsushi Kobori ◽

Natsuhiko Ehara ◽

...

Keyword(s):

Cardiac Death ◽

Poor Prognosis ◽

Coronary Intervention ◽

Killip Class ◽

Percutaneous Coronary ◽

Long Term Follow Up ◽

The Mean ◽

Long Term Prognosis

Introduction: Ischemic mitral regurgitation (IMR) portends a poor prognosis during long-term follow-up and has been identified as an independent predictor of heart failure (HF) and reduced long-term survival. Despite the poor prognosis with chronic IMR, few studies report the impact of IMR on long-term prognosis in patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI). Methods: We studied 674 consecutive patients with AMI from 2000 to 2006 who underwent emergent coronary angiography and primary PCI, and who were assessed by transthoracic echocardiography during index hospitalization. Primary outcomes were cardiac death and the development of HF during follow-up. Results: The mean age of the study patients was 65±12 years and 534 patients (79%) were men. Sixty patients (9%) had moderate or severe MR before hospital discharge. Patients with moderate or severe MR were older, more frequently non-smoker, and more likely to have Killip class ≥2, lower ejection fraction, larger left ventricular end-diastolic volume, compared with patients with no or mild MR. During the mean follow-up period of 5.7±3.6 years, 35 cardiac deaths and 53 episodes of HF occurred. Kaplan-Meier analysis revealed that patients with moderate or severe MR had significantly increased risk for cardiac death (P<0.001), and HF (P<0.001), compared with patients with no or mild MR. Multivariate analysis revealed that moderate or severe MR was the significant predictor of the development of cardiac death (P<0.001), and the development of HF (P=0.006), independently of age, gender, history of MI, Killip class ≥2, initial TIMI flow≤1, peak CPK level, ejection fraction. Conclusions: Moderate or severe IMR detected early after AMI was independently associated with adverse cardiac events during long-term follow-up in patients with AMI after primary PCI.

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A Long-Term Follow-Up of Participants in the Trois-Rivières Semi-Longitudinal Study of Growth and Development

Pediatric Exercise Science ◽

10.1123/pes.10.4.366 ◽

1998 ◽

Vol 10 (4) ◽

pp. 366-377 ◽

Cited By ~ 19

Author(s):

François Trudeau ◽

Louis Laurencelle ◽

Janie Tremblay ◽

Mirjana Rajic ◽

Roy J. Shephard

Keyword(s):

Growth And Development ◽

Perceived Barriers ◽

Control Group ◽

Attitudes And Beliefs ◽

Long Term Follow Up ◽

Experimental Subjects ◽

Back Problems ◽

Experimental Group

The purpose of this project was to undertake a long-term follow-up of participants in the Trois-Rivières Growth and Development Study. Some 20 years after their initial involvement in the program, two groups were compared: experimental subjects (n =150) who had received 5 one-hour sessions of specialized physical education per week throughout their 6 years of primary school, and the original control group (n = 103). All subjects completed a questionnaire regarding current patterns of physical activity (PA), attitudes and beliefs about PA, and perceived barriers to PA. Principal results indicate: (a) More experimental than control women exercise 3 times or more per week, (b) experimental subjects more commonly perceived their health to be very good to excellent, (c) control subjects in general felt less psychological dependency on exercise, and (d) women in the experimental group had a lower relative risk of back problems.

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Whiplash Headache is Transitory Worsening of a Pre-Existing Primary Headache

Cephalalgia ◽

10.1111/j.1468-2982.2008.01615.x ◽

2008 ◽

Vol 28 (1_suppl) ◽

pp. 28-31 ◽

Cited By ~ 14

Author(s):

LJ Stovner ◽

D Obelieniene

Keyword(s):

Neck Pain ◽

Primary Headache ◽

Control Group ◽

Primary Headaches ◽

Headache Diagnosis ◽

Police Records ◽

Characteristic Features ◽

Long Term Prognosis ◽

Chronic Whiplash

Acute and chronic whiplash headache are new diagnostic entities in the ICHD-2 (5.3, 5.4). In a prospective cohort study, 210 rear-end collision victims were identified consecutively from police records and asked about head and neck pain in questionnaires after 2 weeks, 3 months and 1 year. The results were compared with those of matched controls who were also followed for 1 year. Of 210 accident victims, 75 developed headache within 7 days. Of these, 37 had also neck pain and complied with the criteria for acute whiplash headache. These 37 had the same headache diagnoses, headache features, accompanying symptoms and long-term prognosis as the 38 without initial neck pain who therefore did not comply with the acute whiplash headache diagnosis. Previous headache was a major risk factor for headache both in the acute and chronic stage. Compared with the non-traumatized controls, headache in the whiplash group had the same prevalence, the same diagnoses and characteristic features, and the same prognosis. Both acute and chronic whiplash headache lack specificity compared with the headache in a control group, and have the same long-term prognosis, indicating that such headaches are primary headaches, probably elicited by the stress of the situation.

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Supratentorial Brain AVM Embolization with Onyx-18 and Post-Embolization Management

Interventional Neuroradiology ◽

10.1177/159101990901500304 ◽

2009 ◽

Vol 15 (3) ◽

pp. 275-282 ◽

Cited By ~ 9

Author(s):

J. W. Pan ◽

H.J. Zhou ◽

R.Y. Zhan ◽

S. Wan ◽

M. Yan ◽

...

Keyword(s):

Arteriovenous Malformations ◽

Subsequent Treatment ◽

Additional Surgery ◽

Brain Avm ◽

Initial Symptoms ◽

Complete Obliteration ◽

Long Term Follow Up ◽

Long Term Prognosis

Onyx is increasingly used in endovascular therapy of intracranial arteriovenous malformations (AVMs). However, the embolic effect and post-embolization management are still under discussion. We report our experience in the treatment of supratentorial brain arteriovenous malformations (SBAVMs) with Onyx and discuss post-embolic management. From June 2006 to July 2008, 20 patients with SBAVM were embolized with Onyx. There were 14 men and six women ranging from 14 to 64 years of age (mean 38.3 years). Initial symptoms included spontaneous hemorrhage (n=12), headaches (n=4), seizure (n=3) and incidentally disclosed after head trauma (n=1). After the endovascular procedure, all had subsequent treatment (follow-up angiogram, stereotactic radiosurgery or microsurgery) according to the obliteration degree. At angiography, seven patients (35%, 7/20) were completely obliterated (over 95% closure) after embolization while one suffered a small subarachnoid hemorrhage without permanent clinical sequelae. Four patients (20%, 4/20) were subtotally obliterated (over 80% closure), one patient who suffered severe cerebral edema after embolization underwent decompressive craniectomy, two patients had additional radiosurgery and one patient had follow-up angiogram. Nine patients (45%, 9/20) were partially obliterated (20–80% closure), five patients had additional surgery, two patients had additional radiosurgery and two patients had follow-up angiogram (one patient had intraventricular hemorrhage three months after embolization). Of all 20 AVMs, an average of 2.2 ml Onyx was used per patient and average volume reduction was 80% (range, 30%–99%). Onyx is suitable for embolization of SBAVMs because of its diffuse controllable properties. We suggest clinical follow-up after complete obliteration, additional radiosurgery or angiographic follow-up after subtotal obliteration and additional surgery after partially obliteration. More cases with long-term follow-up are needed to evaluate the long-term prognosis of our post-embolization management.

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Impact of new onset atrial fibrillation on long-term prognosis in patients with acute ST-segment elevation myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.0493 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M.A Baturova ◽

M.M Demidova ◽

J Carlson ◽

D Erlinge ◽

P.G Platonov

Keyword(s):

Clinical Characteristics ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

All Cause Mortality ◽

Long Term Follow Up ◽

Long Term Prognosis ◽

New Onset

Abstract Introduction New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF affects the long-term prognosis to the same extent as pre-existing AF is not fully clarified and prescription of oral anticoagulants (OAC) in patients with new-onset AF remains a matter of debates. Purpose We aimed to assess the impact of new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI) on outcome during long-term follow-up in comparison with pre-existing AF and to evaluate effect of OAC therapy in patients with new-onset AF on survival. Methods Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010 (age 66±12 years, 70% male). AF prior to STEMI was documented by record linkage with the Swedish National Patient Register and review of ECGs obtained from the digital archive containing ECGs recorded in the hospital catchment area since 1988. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF and OAC at discharge. All-cause mortality was assessed using the Swedish Cause-of-Death Register 8 years after discharge. Results AF prior to STEMI was documented in 177 patients (8%). Among patients without pre-existing AF (n=2100), new-onset AF was identified in 151 patients (7%). Patients with new-onset AF were older than those without AF history (74±9 vs 65±12 years, p<0.001), but did not differ in regard to other clinical characteristics. Among 2149 STEMI survivors discharged alive, 523 (24%) died during 8 years of follow-up. OAC was prescribed at discharge in 45 (32%) patients with new onset AF and in 49 (31%) patients with pre-existing AF, p=0.901. In a univariate analysis, both new-onset AF (HR 2.18, 95% CI 1.70–2.81, p<0.001) and pre-existing AF (HR 2.80, 95% CI 2.25–3.48, p<0.001) were associated with all-cause mortality, Figure 1. After adjustment for age, gender, cardiac failure, diabetes, BMI and smoking history, new-onset AF remained an independent predictor of all-cause mortality (HR 1.40, 95% CI 1.02–1.92, p=0.037). OAC prescribed at discharge in patients with new-onset AF was not significantly associated with survival (univariate HR 0.86, 95% CI 0.50–1.50, p=0.599). Conclusion New-onset AF developed during hospital admission with STEMI is common and independently predicts all-cause mortality during long-term follow-up after STEMI with risk estimates similar to pre-existing AF. The effect of OAC on survival in patients with new-onset AF is inconclusive as only one third of them received OAC therapy at discharge. Kaplan-Meier survival curve Funding Acknowledgement Type of funding source: None

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